Homer Bell was 54 years old when he killed himself in April in a very public way — he laid down his head in front of a stopped bus in his hometown of Hartford, Conn. It was the last act in a life filled with struggle, as Bell and his family endured his schizophrenia.

At a time when there are calls to strengthen the mental health system, Bell's story shows how hard coping with mental illness can be.

Harold Schwartz, the psychiatrist in chief for Hartford Hospital's Institute of Living, describes some of the difficulties for a family: It's hard to get help, provide a home, and give the right kind of support. Bell's struggle to deal with the frightening voices in his head led to outbursts of anger, and even some run-ins with the police.

Rosalind Scott, Bell's mother, says he was living on the streets and had gone to a hospital for help. In the days after his release, he showed up repeatedly on her porch. One night she let him into the hallway to get warm. But it was hard to let him in farther. Homer could be loud, he could be angry, he could be paranoid. His illness had exhausted her.

One or two nights later when Homer came back, his mother was tired and, wanting relief, she didn't let him in. She explains why:

After the death and the funeral, Scott went through her voice mails. She had dozens. And then she heard Homer's voice and stopped. "That's when he apologized to the family," she says.

Scott says she has a particular regret.

Psychiatrist Schwartz has been a part of the conversation about Connecticut's mental health system that has gained new urgency since the school shootings in Newtown. He says a lot of attention is now being paid to identifying young people with emotional struggles who need help, but when it comes to helping people like Bell — the homeless, chronically mentally ill adult living in the community — he sees less movement.

And in some cases wisdom, patience and compassion aren't enough. He says sometimes suicidal intent is a terminal disease.

It's a reality, Schwartz says, that for Bell's family — and for many others — can be hard to hear.